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Clinical Added Value of SARS-CoV-2 Antigen Detection in Blood Samples. Diagnostics (Basel) 2022; 12:diagnostics12102427. [PMID: 36292116 PMCID: PMC9600523 DOI: 10.3390/diagnostics12102427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 11/24/2022] Open
Abstract
This study evaluated the performances of immunoassays (LFIA and ELISA) designed for SARS-CoV-2 Antigen (Ag)-detection in nasopharyngeal (NP) and serum samples in comparison to RT-PCR. NP samples from patients with respiratory symptoms (183 RT-PCR-positive and 74 RT-PCR-negative samples) were collected from March to April and November to December 2020. Seroconversion and antigen dynamics were assessed by symptom onset and day of RT-PCR diagnosis. Serum samples from 87 COVID-19 patients were used to investigate the added value of Ag quantification, at diagnosis and during follow-up. The sensitivity of COVID-VIRO-LFIA on samples with Ct ≤ 33, considered as the contagious threshold, was 86% on NPs (CI 95%: 79–90.5) and 76% on serum samples (CI 95%: 59.4–88), with a specificity of 100%. Serum N-Ag was detected during active infection as early as day two from symptom onset, with a diagnostic sensitivity of 81.5%. Within one week of symptom onset, diagnostic sensitivity and specificity reached 90.9% (95% CI, 85.1%–94.6%) and 98.3% (95% CI, 91.1%–99.9%), respectively. Serum N-Ag concentration closely correlated with disease severity. Longitudinal analysis revealed the simultaneous increase of antibodies and decrease of N-Ag. Sensitivities of COVID-VIRO-LFIA and COV-QUANTO-ELISA tests on NP and serum samples were close to 80%. They are suitable COVID-19-laboratory diagnostic tests, particularly when blood samples are available, thus reducing the requirement for NP sampling, and subsequent PCR analysis. ELISA titers may help to identify patients at risk of poor outcomes.
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Professional regulation, profession-state relations and the pandemic response: Australia, Canada, and the UK compared. Soc Sci Med 2022; 296:114808. [PMID: 35182959 PMCID: PMC8837473 DOI: 10.1016/j.socscimed.2022.114808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 11/03/2021] [Accepted: 02/10/2022] [Indexed: 11/29/2022]
Abstract
The COVID-19 pandemic provoked a surge in demand for health services. To help meet this demand, governments and health profession regulators implemented regulatory policy change to enhance professional availability and flexibility. Some nations may have been better positioned to make such changes due to their systems of healthcare profession regulation. More specifically, countries like Australia and the United Kingdom with their national regulatory structures could be more adaptable than Canada with its provincial system of regulation. To determine if this is the case, and guided by Abbott's (1988, 2005) ecological approach, we conducted a policy analysis. We find few differences in regulatory policy changes in terms of what was done, with the exception of scope of practice changes, which were implemented in Canadian provinces, but were not necessary in Australia and the United Kingdom. Instead, in the latter two countries practitioners were asked to bear responsibility for their own scopes. Additional content analysis of medical journals explored what professionals thought about policy responses, finding that Australian professionals were more positive than others. Moreover, government responses were regarded more favourably when they were perceived to be collaborative. Although there is little evidence that one regulatory system is better than another in facilitating crisis responses, regulatory structures do shape the nature of regulatory policy change.
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Brown C, Wilkins K, Craig-Neil A, Upshaw T, Pinto AD. Reducing Inequities During the COVID-19 Pandemic: A Rapid Review and Synthesis of Public Health Recommendations. Public Health Rev 2022; 42:1604031. [PMID: 35140994 PMCID: PMC8802804 DOI: 10.3389/phrs.2021.1604031] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 11/04/2021] [Indexed: 01/10/2023] Open
Abstract
Objectives: Efforts to contain the COVID-19 pandemic should take into account worsening health inequities. While many public health experts have commented on inequities, no analysis has yet synthesized recommendations into a guideline for practitioners. The objective of this rapid review was to identify the areas of greatest concern and synthesize recommendations. Methods: We conducted a rapid systematic review (PROSPERO: CRD42020178131). We searched Ovid MEDLINE, Embase, PsycINFO, CINAHL and Cochrane Central Register of Controlled Trials databases from December 1, 2019 to April 27, 2020. We included English language peer-reviewed commentaries, editorials, and opinion pieces that addressed the social determinants of health in the context of COVID-19. Results: 338 articles met our criteria. Authors represented 81 countries. Income, housing, mental health, age and occupation were the most discussed social determinants of health. We categorized recommendations into primordial, primary, secondary and tertiary prevention that spoke to the social determinants of COVID-19 and equity. Conclusion: These recommendations can assist efforts to contain COVID-19 and reduce health inequities during the pandemic. Using these recommendations, public health practitioners could support a more equitable pandemic response. Systematic Review Registration: PROSPERO, CRD42020178131.
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Affiliation(s)
- Chloe Brown
- Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada
- Undergraduate Medical Education, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Katie Wilkins
- Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada
- Undergraduate Medical Education, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Amy Craig-Neil
- Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada
| | - Tara Upshaw
- Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada
| | - Andrew David Pinto
- Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Family and Community Medicine, St. Michael's Hospital, Toronto, ON, Canada
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4
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Pandi-Perumal SR, Vaccarino SR, Chattu VK, Zaki NF, BaHammam AS, Manzar D, Maestroni GJM, Suchecki D, Moscovitch A, Zizi F, Jean-Louis G, Narasimhan M, Ramasubramanian C, Trakht I, Seeman MV, Shneerson JM, Maes M, Reiter RJ, Kennedy SH. 'Distant socializing,' not 'social distancing' as a public health strategy for COVID-19. Pathog Glob Health 2021; 115:357-364. [PMID: 34057046 PMCID: PMC8592617 DOI: 10.1080/20477724.2021.1930713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Social distancing, also referred to as physical distancing, means creating a safe distance of at least two meters (six feet) between yourself and others. This is a term popularized during the COVID-19 pandemic, as it is one of the most important measures to prevent the spread of this virus. However, the term 'social distancing' can be misleading, as it may imply that individuals should stop socializing. However, socializing in a safe context (i.e. over the phone, video-chat, etc.) is especially important during this time of crisis. Therefore, in this narrative review, we suggest the term 'distant socializing' as more apt expression, to promote physical distancing measures while also highlighting the importance of maintaining social bonds. Further, articles discussing the practice, implementation, measurement, and mental health effects of physical distancing are reviewed. Physical distancing is associated with psychiatric symptoms (such as anxiety and depression), suicidal ideation, and domestic violence. Further, unemployment and job insecurity have significantly increased during COVID-19, which may exacerbate these negative mental health effects. Governments, medical institutions, and public health bodies should therefore consider increasing mental health resources both during and after the pandemic, with a specific focus on frontline workers, COVID-19 survivors, and marginalized communities.
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Affiliation(s)
| | - Sophie R. Vaccarino
- Centre for Depression and Suicide Studies, St. Michael’s Hospital, Toronto, Canada
| | | | - Nevin F.W. Zaki
- Department of Psychiatry, Mansoura University, Mansoura, Egypt
| | - Ahmed S. BaHammam
- Department of Medicine, College of Medicine, University Sleep Disorders Center, King Saud University, Riyadh, Saudi Arabia
- The Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, Saudi Arabia
| | - Dilshad Manzar
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - G J M Maestroni
- Center of Research in Medical Pharmacology, University of Insubria, Varese, Italy
| | - Deborah Suchecki
- Departamento De Psicobiologia, Escola Paulista De Medicina, Universidade Federal De São Paulo, São Paulo, Brazil
| | - Adam Moscovitch
- Department of Psychiatry, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ferdinand Zizi
- Department of Population Health, Center for Healthful Behavioral Change, NYU Grossman School of Medicine, New York, USA
| | - Girardin Jean-Louis
- Department of Population Health, Center for Healthful Behavioral Change, NYU Grossman School of Medicine, New York, USA
- Department of Psychiatry, NYU Grossman School of Medicine, New York, USA
| | - Meera Narasimhan
- Department of Psychiatry and Behavioral Science, Columbia, University of South Carolina, South Carolina, USA
- Department of Neuropsychiatry and Behavioral Science, Columbia, University of South Carolina, South Carolina, USA
| | | | - Ilya Trakht
- Department of Medicine, Columbia University, New York, NY, USA
| | | | - John M Shneerson
- Respiratory Support & Sleep Center, Royal Papworth Hospital, Cambridge, England, UK
| | - Michael Maes
- Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand
| | - Russel J Reiter
- Department of Cellular & Structural Biology, UT Health San Antonio, TX, USA
| | - Sidney H. Kennedy
- Centre for Depression and Suicide Studies, St. Michael’s Hospital, Toronto, Canada
- Department of Psychiatry, University of Toronto, Canada
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5
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The Impact of the Social Distancing Policy on COVID-19 Incidence Cases and Deaths in Iran from February 2020 to January 2021: Insights from an Interrupted Time Series Analysis. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2021; 94:13-21. [PMID: 33795979 PMCID: PMC7995950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Background: In December 2019, a viral outbreak occurred in China, and rapidly spread out worldwide. Due to the lack of immediately available vaccines and effective drugs, many policy- and decision-makers have focused on non-pharmacological methods, including social distancing. This study was aimed at assessing the effects of the implementation of this policy in Iran, one of the countries most affected by COVID-19. We conducted a quasi-experimental study, utilizing the interrupted time series analysis (ITSA) approach. Methods: We collected daily data between February 20, 2020 and January 29, 2021, through governmental websites from 954 public hospitals and healthcare settings. The Iranian government launched the social distancing policy on March 27, 2020. Statistical analyses, including ITSA, were carried out with R software Version 3.6.1 (London, UK). Results: During the study period, 1,398,835 confirmed incidence cases and 57,734 deaths occurred. We found a decrease of -179.93 (95% CI: -380.11 to -20.25, P-value=0.078) confirmed incidence cases following the implementation of the social distancing policy, corresponding to a daily decrease in the trend of -31.17 (95% CI: -46.95 to -15.40, P-value=0.08). Moreover, we found a decrease of -28.28 (95% CI: -43.55 to -13.01, P-value=0.05) deaths, corresponding to a daily decrease in the trend of -4.52 (95% CI: -5.25 to -3.78, P-value=0.003). Conclusion: The growth rate of confirmed incidence cases and deaths from COVID-19 in Iran has decreased from March 27, 2020 to January 29, 2021, after the implementation of social distancing. By implementing this policy in all countries, the burden of COVID-19 may be mitigated.
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Dortet L, Ronat JB, Vauloup-Fellous C, Langendorf C, Mendels DA, Emeraud C, Oueslati S, Girlich D, Chauvin A, Afdjei A, Bernabeu S, Le Pape S, Kallala R, Rochard A, Verstuyft C, Fortineau N, Roque-Afonso AM, Naas T. Evaluating 10 Commercially Available SARS-CoV-2 Rapid Serological Tests by Use of the STARD (Standards for Reporting of Diagnostic Accuracy Studies) Method. J Clin Microbiol 2021; 59:e02342-20. [PMID: 33239381 PMCID: PMC8111137 DOI: 10.1128/jcm.02342-20] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 11/21/2020] [Indexed: 02/07/2023] Open
Abstract
Numerous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rapid serological tests have been developed, but their accuracy has usually been assessed using very few samples, and rigorous comparisons between these tests are scarce. In this study, we evaluated and compared 10 commercially available SARS-CoV-2 rapid serological tests using the STARD (Standards for Reporting of Diagnostic Accuracy Studies) methodology. Two hundred fifty serum samples from 159 PCR-confirmed SARS-CoV-2 patients (collected 0 to 32 days after the onset of symptoms) were tested with rapid serological tests. Control serum samples (n = 254) were retrieved from pre-coronavirus disease (COVID) periods from patients with other coronavirus infections (n = 11), positivity for rheumatoid factors (n = 3), IgG/IgM hyperglobulinemia (n = 9), malaria (n = 5), or no documented viral infection (n = 226). All samples were tested using rapid lateral flow immunoassays (LFIAs) from 10 manufacturers. Only four tests achieved ≥98% specificity, with the specificities ranging from 75.7% to 99.2%. The sensitivities varied by the day of sample collection after the onset of symptoms, from 31.7% to 55.4% (days 0 to 9), 65.9% to 92.9% (days 10 to 14), and 81.0% to 95.2% (>14 days). Only three of the tests evaluated met French health authorities' thresholds for SARS-CoV-2 serological tests (≥90% sensitivity and ≥98% specificity). Overall, the performances varied greatly between tests, with only one-third meeting acceptable specificity and sensitivity thresholds. Knowledge of the analytical performances of these tests will allow clinicians and, most importantly, laboratorians to use them with more confidence; could help determine the general population's immunological status; and may help diagnose some patients with false-negative real-time reverse transcription-PCR (RT-PCR) results.
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Affiliation(s)
- Laurent Dortet
- Bacteriology-Hygiene Unit, Bicêtre Hospital, Associated French National Reference Center for Antibiotic Resistance: Carbapenemase-Producing Enterobacteriaceae, Assistance Publique/Hôpitaux de Paris, Le Kremlin-Bicêtre, France
- Team Resist UMR1184 Immunology of Viral, Auto-immune, Hematological, and Bacterial Diseases (IMVA-HB), INSERM, Université Paris-Saclay, LabEx Lermit, Faculty of Medicine, Le Kremlin-Bicêtre, France
| | - Jean-Baptiste Ronat
- Team Resist UMR1184 Immunology of Viral, Auto-immune, Hematological, and Bacterial Diseases (IMVA-HB), INSERM, Université Paris-Saclay, LabEx Lermit, Faculty of Medicine, Le Kremlin-Bicêtre, France
- Médecins Sans Frontières, Mini-Lab Project, Paris, France
| | - Christelle Vauloup-Fellous
- Service de Virologie, Hôpital Paul-Brousse, Villejuif, France
- INSERM U1193, Université Paris-Saclay, Villejuif, France
| | | | | | - Cécile Emeraud
- Bacteriology-Hygiene Unit, Bicêtre Hospital, Associated French National Reference Center for Antibiotic Resistance: Carbapenemase-Producing Enterobacteriaceae, Assistance Publique/Hôpitaux de Paris, Le Kremlin-Bicêtre, France
- Team Resist UMR1184 Immunology of Viral, Auto-immune, Hematological, and Bacterial Diseases (IMVA-HB), INSERM, Université Paris-Saclay, LabEx Lermit, Faculty of Medicine, Le Kremlin-Bicêtre, France
| | - Saoussen Oueslati
- Team Resist UMR1184 Immunology of Viral, Auto-immune, Hematological, and Bacterial Diseases (IMVA-HB), INSERM, Université Paris-Saclay, LabEx Lermit, Faculty of Medicine, Le Kremlin-Bicêtre, France
| | - Delphine Girlich
- Team Resist UMR1184 Immunology of Viral, Auto-immune, Hematological, and Bacterial Diseases (IMVA-HB), INSERM, Université Paris-Saclay, LabEx Lermit, Faculty of Medicine, Le Kremlin-Bicêtre, France
| | - Anthony Chauvin
- Emergency Departement, Hopital Lariboisière, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine Paris Diderot, Université de Paris, Paris, France
| | - Ali Afdjei
- Emergency Department, Hôpital Parly-2, Le Chesnay, France
| | - Sandrine Bernabeu
- Bacteriology-Hygiene Unit, Bicêtre Hospital, Associated French National Reference Center for Antibiotic Resistance: Carbapenemase-Producing Enterobacteriaceae, Assistance Publique/Hôpitaux de Paris, Le Kremlin-Bicêtre, France
- Team Resist UMR1184 Immunology of Viral, Auto-immune, Hematological, and Bacterial Diseases (IMVA-HB), INSERM, Université Paris-Saclay, LabEx Lermit, Faculty of Medicine, Le Kremlin-Bicêtre, France
| | - Samuel Le Pape
- Service de Virologie, Hôpital Paul-Brousse, Villejuif, France
| | - Rim Kallala
- Service de Virologie, Hôpital Paul-Brousse, Villejuif, France
| | - Alice Rochard
- Team Resist UMR1184 Immunology of Viral, Auto-immune, Hematological, and Bacterial Diseases (IMVA-HB), INSERM, Université Paris-Saclay, LabEx Lermit, Faculty of Medicine, Le Kremlin-Bicêtre, France
| | | | - Nicolas Fortineau
- Bacteriology-Hygiene Unit, Bicêtre Hospital, Associated French National Reference Center for Antibiotic Resistance: Carbapenemase-Producing Enterobacteriaceae, Assistance Publique/Hôpitaux de Paris, Le Kremlin-Bicêtre, France
- Team Resist UMR1184 Immunology of Viral, Auto-immune, Hematological, and Bacterial Diseases (IMVA-HB), INSERM, Université Paris-Saclay, LabEx Lermit, Faculty of Medicine, Le Kremlin-Bicêtre, France
| | - Anne-Marie Roque-Afonso
- Service de Virologie, Hôpital Paul-Brousse, Villejuif, France
- INSERM U1193, Université Paris-Saclay, Villejuif, France
| | - Thierry Naas
- Bacteriology-Hygiene Unit, Bicêtre Hospital, Associated French National Reference Center for Antibiotic Resistance: Carbapenemase-Producing Enterobacteriaceae, Assistance Publique/Hôpitaux de Paris, Le Kremlin-Bicêtre, France
- Team Resist UMR1184 Immunology of Viral, Auto-immune, Hematological, and Bacterial Diseases (IMVA-HB), INSERM, Université Paris-Saclay, LabEx Lermit, Faculty of Medicine, Le Kremlin-Bicêtre, France
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7
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Polcwiartek LB, Polcwiartek C, Andersen MP, Østergaard L, Broccia MD, Gislason GH, Køber L, Torp-Pedersen C, Schou M, Fosbøl E, Kragholm K, Hagstrøm S. Consequences of coronavirus disease-2019 (COVID-19) lockdown on infection-related hospitalizations among the pediatric population in Denmark. Eur J Pediatr 2021; 180:1955-1963. [PMID: 33555426 PMCID: PMC7868522 DOI: 10.1007/s00431-021-03934-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 11/30/2020] [Accepted: 01/06/2021] [Indexed: 12/12/2022]
Abstract
It remains unknown how Coronavirus disease-2019 (COVID-19) prevention measures implemented on March 12, 2020, have affected the rate of pediatric infection-related hospitalizations in Denmark. Therefore, we investigated the rate of pediatric infection-related hospitalizations during the COVID-19 pandemic. We used a retrospective cohort design and included all Danish children < 18 years. Infection-related hospitalizations were assessed during study periods in 2020 vs. 2018/2019, and we computed incidence rate ratios (IRRs) with 95% confidence intervals (CIs) using Poisson regression. In the 2020 study period, 3093 children were hospitalized with an infection, while the corresponding figures for 2018 and 2019 study periods were 4824 and 3830, respectively. When comparing the 2020 to the 2018/2019 study period prior to nationwide lockdown, we observed a decline in infection-related hospitalizations (12.68 (95% CI, 12.22-13.16) vs. 15.49 (95% CI, 15.12-15.86) per 1000 person-years). We further observed decreased IRRs, especially during the lockdown period (week 11: 0.64 (95% CI, 0.55-0.75); week 12: 0.26 (95% CI, 0.21-0.33); week 13: 0.13 (95% CI, 0.10-0.19)).Conclusion: The rate of pediatric infection-related hospitalizations in Denmark declined during the COVID-19 pandemic in 2020 compared to that in 2018/2019, with a 36% decline during initiation of the nationwide lockdown period. What is Known: • Due to the COVID-19 pandemic, several countries have implemented mitigation strategies such as lockdown of non-critical business functions. Most of these strategies have previously been proven effective on interruption of infection transmission. • It remains unclear how the mitigation strategies have affected the rate of pediatric infection-related hospitalizations. What is New: • Insight on how COVID-19 prevention measures have affected the frequency of infection-related hospitalization. • Valuable knowledge on how to act in potential future pandemics.
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Affiliation(s)
- Laura Bech Polcwiartek
- Department of Pediatrics, Aalborg University Hospital, Reberbansgade 15, 9000, Aalborg, Denmark.
| | - Christoffer Polcwiartek
- Department of Cardiology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark
| | - Mikkel Porsborg Andersen
- Department of Clinical Research, Nordsjaellands Hospital, Dyrehavevej 29, 3400 Hillerød, Denmark
| | - Lauge Østergaard
- Department of Cardiology, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Marcella D. Broccia
- Department of Clinical Research, Nordsjaellands Hospital, Dyrehavevej 29, 3400 Hillerød, Denmark ,Department of Obstetrics and Gynecology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark
| | - Gunnar H. Gislason
- The Danish Heart Foundation, Vognmagergade 7, 3. sal, 1120 Copenhagen, Denmark ,Department of Cardiology, Copenhagen University Hospital, Herlev and Gentofte, Gentofte Hospitalsvej 1, 2900 Hellerup, Denmark
| | - Lars Køber
- Department of Cardiology, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Christian Torp-Pedersen
- Department of Cardiology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark ,Department of Clinical Research, Nordsjaellands Hospital, Dyrehavevej 29, 3400 Hillerød, Denmark
| | - Morten Schou
- Department of Cardiology, Copenhagen University Hospital, Herlev and Gentofte, Gentofte Hospitalsvej 1, 2900 Hellerup, Denmark
| | - Emil Fosbøl
- Department of Cardiology, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Kristian Kragholm
- Department of Cardiology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark ,Department of Cardiology, North Denmark Regional Hospital, Bispensgade 37, 9800 Hjørring, Denmark ,Unit of Clinical Biostatistics and Epidemiology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark
| | - Søren Hagstrøm
- Department of Pediatrics, Aalborg University Hospital, Reberbansgade 15, 9000 Aalborg, Denmark ,Center for Clinical Research, North Denmark Regional Hospital, Bispensgade 37, 9800 Hjørring, Denmark ,Department of Clinical Medicine, Aalborg University, Hobrovej 18-22, 9000 Aalborg, Denmark
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8
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Dortet L, Emeraud C, Vauloup-Fellous C, Khecharem M, Ronat JB, Fortineau N, Roque-Afonso AM, Naas T. Rapid Determination of SARS-CoV-2 antibodies using a bedside, point-of-Care, serological test. Emerg Microbes Infect 2020; 9:2212-2221. [PMID: 32969769 PMCID: PMC7580567 DOI: 10.1080/22221751.2020.1826892] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background: Several serological tests for SARS-CoV-2 have been developed or use, but most have only been validated on few samples, and none provide medical practitioners with an easy-to-use, self-contained, bedside test with high accuracy. Material and methods: Two-hundred fifty-six sera from 101 patients hospitalized with SARS-CoV-2 infection (positive RT–PCR) and 50 control sera were tested for IgM/IgG using the NG-Test IgM-IgG COVID all-in-one assay. The seroconversion dynamic was assessed by symptom onset and day of RT–PCR diagnosis. Results: Among the SARS-CoV-2 infected patients, positive IgG and/or IgM result was observed for 67.3% of patients (68/101), including 17 (16.8%) already positive at the day of RT–PCR, and 51 (50.5%) with observable seroconversion, and 32.7% (33/101) remained negative as subsequent sampling was not possible (patient discharge or death). The sensitivity increased with the delay between onset of symptoms and sampling, going from 29.1%, 78.2% and 86.5% for the time periods of 0-9-, 10-14- and >14-days after the onset of symptoms, respectively. Cumulative sensitivity, specificity, Positive Predictive Value and Negative Predictive Value were 97.0%, 100%, 100% and 96.2%, respectively 15-days after the onset of symptoms. No difference in seroconversion delay was observed regardless of whether patients received ventilation. Conclusions: The NG-test is a bedside serological assay that could serve as a complementary source of diagnostic information to RT–PCR and chest imaging. It may also be useful to monitor immunological status of medical and non-medical workers during the ongoing pandemic, and the general population after social distancing measures have eased.
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Affiliation(s)
- Laurent Dortet
- Service de Bactériologie-hygiène, Hôpital Bicêtre, Inserm U1184; LabEx LERMIT, Université Paris-Saclay, APHP Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Cecile Emeraud
- Service de Bactériologie-hygiène, Hôpital Bicêtre, Inserm U1184; LabEx LERMIT, Université Paris-Saclay, APHP Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Christelle Vauloup-Fellous
- Service de Virologie, Hôpital Paul-Brousse, Inserm U1193; Université Paris-Saclay, APHP Paris-Saclay, Villejuif, France
| | - Mouna Khecharem
- Service de Bactériologie-hygiène, Hôpital Bicêtre, Inserm U1184; LabEx LERMIT, Université Paris-Saclay, APHP Paris-Saclay, Le Kremlin-Bicêtre, France
| | | | - Nicolas Fortineau
- Service de Bactériologie-hygiène, Hôpital Bicêtre, Inserm U1184; LabEx LERMIT, Université Paris-Saclay, APHP Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Anne-Marie Roque-Afonso
- Service de Virologie, Hôpital Paul-Brousse, Inserm U1193; Université Paris-Saclay, APHP Paris-Saclay, Villejuif, France
| | - Thierry Naas
- Service de Bactériologie-hygiène, Hôpital Bicêtre, Inserm U1184; LabEx LERMIT, Université Paris-Saclay, APHP Paris-Saclay, Le Kremlin-Bicêtre, France
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9
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Kramer CK, Retnakaran R. Rates of COVID-19-associated hospitalization in British Columbia and Ontario: time course of flattening the relevant curve. Canadian Journal of Public Health 2020; 111:636-640. [PMID: 32875520 PMCID: PMC7461746 DOI: 10.17269/s41997-020-00405-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/18/2020] [Indexed: 11/18/2022]
Abstract
The objective of social distancing is to slow the rate of viral transmission and thereby spread out the incidence of coronavirus disease 2019 (COVID-19) cases over time (i.e., flattening the curve) so that a surge of patients will not overwhelm the capacity of the healthcare system. Given this objective, the specific curve that requires flattening is that of COVID-19-associated hospitalizations. In this context, we evaluated the rates of COVID-19-associated hospitalization in British Columbia (BC) and Ontario to see if either province shows evidence of flattening the relevant curve. From late March to mid-June 2020, the cumulative rate of COVID-19-associated hospitalization in BC has indeed shown evidence of flattening, whereas that in Ontario has increased linearly. The cumulative hospitalization rate in Ontario first surpassed that of BC on April 14. By June 18, the respective hospitalization rates per 100,000 population were 27.86 for Ontario and 9.96 for BC. In both provinces, the cumulative hospitalization rate has remained lower than that of comparator US states. In conclusion, there is evidence of flattening the relevant curve in BC but not yet in Ontario. The comparison with BC underscores the need for continued caution with the relaxation of social distancing efforts in Ontario.
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Affiliation(s)
- Caroline K Kramer
- Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Mailbox-21, 60 Murray Street, Suite L5-025, Toronto, ON, M5T 3L9, Canada.,Division of Endocrinology, University of Toronto, Toronto, Canada.,Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada
| | - Ravi Retnakaran
- Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Mailbox-21, 60 Murray Street, Suite L5-025, Toronto, ON, M5T 3L9, Canada. .,Division of Endocrinology, University of Toronto, Toronto, Canada. .,Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada.
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Sakelliadis EI, Katsos KD, Zouzia EI, Spiliopoulou CA, Tsiodras S. Impact of Covid-19 lockdown on characteristics of autopsy cases in Greece. Comparison between 2019 and 2020. Forensic Sci Int 2020; 313:110365. [PMID: 32563134 PMCID: PMC7291972 DOI: 10.1016/j.forsciint.2020.110365] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/09/2020] [Accepted: 06/10/2020] [Indexed: 12/17/2022]
Abstract
Frequency of fatal MI seems to remain unaffected by the COVID-19 pandemic. Deaths resulting from road traffic accidents exhibit a significant decrease. Homicides and suicides remain unaffected by the COVID-19 outbreak. Emergency measures prevented overwhelming of the Greek healthcare system.
In order to reduce transmission of COVID-19, social distancing measures were proposed, including spatial distancing (2 m distance), or even generalized lockdown. Main concern was to prevent overwhelming of the healthcare systems, mainly of the intensive care units (ICUs) by decreasing the spreading of the disease. In Greece, the Government, after consulting with experts in the fields of infectious disease and epidemiology, implemented a rather aggressive stance with an early lockdown. Aim of our study, is to identify and compare the characteristics of cases referred for autopsy during the first month of the lockdown period for the COVID-19 outbreak, versus the cases referred during the same period in 2019. 231 autopsy cases were included in our study, 125 in 2019 and 106 in 2020. Regarding gender, age and nationality, no significant differences were detected between the two time periods. Age subgroup analysis demonstrated increased number of cases within the age group 70–79 years, in 2020. As to the place of death, the increase in the percentage of out-of-hospital deaths was not confirmed as statistically significant. Regarding type of death (violent, sudden/unexpected), the drop of violent deaths in the 2020 examined period, was not confirmed as statistically significant; however, further subgroup analysis showed a significant drop of fatal injuries resulting from road traffic accidents in the 2020 period. The slight increase of sudden/unexpected deaths, especially myocardial infarction cases, did not reach statistical significance. One month after lockdown, we cannot detect significant differences in the two time periods examined. Further study should be conducted soon when more data will become available. Frequency of fatal myocardial infarction seems to remain unaffected by the COVID-19 pandemic while deaths resulting from road traffic accidents exhibit a significant decrease. Homicides and suicides remain at low levels, in our jurisdiction area, seemingly unaffected by the COVID-19 outbreak and the subsequent lockdown. It appears that since sudden/unexpected deaths, statistically remain unaffected, the preventive measures taken by the Greek authorities prevented overwhelming of the healthcare system, which could function properly.
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Affiliation(s)
- Emmanouil I Sakelliadis
- Department of Forensic Medicine and Toxicology, Medical School, National and Kapodistrian University of Athens, Greece.
| | - Konstantinos D Katsos
- Department of Forensic Medicine and Toxicology, Medical School, National and Kapodistrian University of Athens, Greece
| | - Evmorfili I Zouzia
- Department of Forensic Medicine and Toxicology, Medical School, National and Kapodistrian University of Athens, Greece
| | - Chara A Spiliopoulou
- Department of Forensic Medicine and Toxicology, Medical School, National and Kapodistrian University of Athens, Greece
| | - Sotirios Tsiodras
- 4th Department of Internal Medicine, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Greece
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Jiang J, Luo L. Influence of population mobility on the novel coronavirus disease (COVID-19) epidemic: based on panel data from Hubei, China. Glob Health Res Policy 2020; 5:30. [PMID: 32518832 PMCID: PMC7276249 DOI: 10.1186/s41256-020-00151-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 05/01/2020] [Indexed: 01/07/2023] Open
Abstract
Background The novel coronavirus disease (COVID-19) was first reported in Wuhan, China. The mass population mobility in China during the Spring Festival has been considered a driver to the transmission of COVID-19, but it still needs more empirical discussion. Methods Based on the panel data from Hubei, China between January 6th and February 6th, 2020, a random effects model was used to estimate the impact of population mobility on the transmission of COVID-19. Stata version 12.0 was used, and p < 0.05 was considered statistically significant. Results The COVID-19 was more likely to be confirmed within 11-12 days after people moved from Wuhan to 16 other prefecture-level cities in Hubei Province, which suggests a period of 11-12 days from contact to being confirmed. The daily confirmed cases and daily increment in incidence in 16 prefecture-level cities show obvious declines 9-12 days post adaptation of city lockdown at the local level. Conclusion Population mobility is found to be a driver to the rapid transmission of COVID-19, and the lockdown intervention in local prefecture-level cities of Hubei Province has been an effective strategy to block the COVID-19 epidemic.
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Affiliation(s)
- Junfeng Jiang
- School of Health Sciences, Wuhan University, No.115 Donghu Road, Wuhan, 430071 China
| | - Lisha Luo
- Center for Evidence-based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- Department of Evidence-Based Medicine and Clinical Epidemiology, the Second Clinical College of Wuhan University, Wuhan, China
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Li HOY, Huynh D. Long-term social distancing during COVID-19: A social isolation crisis among seniors? CMAJ 2020; 192:E588. [PMID: 32575063 DOI: 10.1503/cmaj.75428] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Heidi Oi-Yee Li
- Medical student, Faculty of Medicine, University of Ottawa, Ottawa, Ont
| | - David Huynh
- Research assistant, Department of Health Sciences, Carleton University, Ottawa, Ont
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